Using data from a CSP-funded research demonstration project designed to expand vocational services offered by case management teams serving people with serious mental illness, this paper examines the issues created by employing consumers as peer support specialists for the project. Roles and benefits of these positions are analyzed. Challenges experienced by specialists created by serving peers, the structure of the position, the mental health system and the community, and personal issues are analyzed using data from focus groups and the project's management information system. Implications for consumer role definition, supports for role effectiveness, and the structuring of these types of positions are discussed.
In an effort to expand employment opportunities available to psychiatric consumers, a research demonstration project was developed to incorporate vocational services into case management teams. Following psychiatric rehabilitation principles, Project WINS employs professionals as Vocational Specialists and consumers as Peer Support Specialists to work with clients and their case managers. This report describes the characteristics of clients eligible for WINS services, the implementation of the program, and the impact of WINS on clients and on the mental health and vocational systems. It also describes the challenges and barriers this innovative service is confronting.
Further investigation will be needed to determine whether naltrexone is efficacious among depressed alcohol dependent patients and whether naltrexone and antidepressant medications show interactive efficacy for treating alcohol dependence.
This article summarizes physical health, mental health, and substance abuse problems of users of four of Detroit's largest homeless shelters. Shelter users with mental illness or substance abuse problems were compared with those without these problems. Alcohol abusers were significantly more likely to have low blood pressure, symptoms of liver disease, and a tuberculosis treatment history. No health differences were found for those with or without a history of psychiatric hospitalization. Contrary to expectations, few gender differences were found. Aside from the obvious need for low-income housing, comprehensive and integrated treatment approaches from health care, mental health, and substance abuse agencies are needed to help homeless individuals. Social workers need to become more directly involved in service and policy issues for this vulnerable population.
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